A Bailey chair maintains a dog's vertical, upright posture while he or she eats (and for a few minutes afterward), to help the meal move down the dog's esophagus and into the stomach. Photo courtesy of https://www.facebook.com/baileychairs4dogs.
The esophagus is a muscular, distensible organ that carries food from the mouth to the stomach. Megaesophagus is a common disorder in dogs that describes slow motility with resultant dilation of the esophagus. As a result of hypomotility, food will “pool” in the esophagus and stretch it. The stretching leads to damage to the nerves. This worsens hypomotility — a vicious cycle.
Megaesophagus can be either primary or secondary. In the primary case, an underlying cause is never discovered. It predominantly occurs in puppies, and rarely in an adult-onset form. Secondary occurs when some other predisposing condition such as myasthenia gravis, an autoimmune disease, develops, leading to the megaesophagus.
Primary Megaesophagus in Dogs
Congenital
Unfortunately, some puppies are just born with a flaccid, slow-moving esophagus. Breeds that are genetically predisposed include the wire-haired fox terrier and miniature Schnauzer, but any breed can be affected. Initial symptoms may not be seen until a puppy is transitioned from maternal milk to dog food. Then symptoms of regurgitation and secondary pneumonia are noted. Regurgitation is different from vomiting. It occurs almost directly after a meal. Often the food comes back up with no effort, almost like a burp, and no digestion has occurred.
A frequent secondary consequence of regurgitation is aspiration pneumonia. As a puppy regurgitates while inhaling, food and stomach acid can be pulled into the lungs. In these cases, puppies must be treated for aspiration. This can include oxygen therapy, nebulization and coupage, and sometimes antibiotics. Hospitalization may be needed if the pneumonia is severe.
There is no surgical treatment for this type of megaesophagus; it can be managed with a variety of life-style changes. These include feeding and watering in an upright position using a Bailey chair (click here for a link to a company that manufactures custom Bailey chairs) with small, frequent, calorically dense meals. Some dogs do better with gruel while others prefer meatballs. It will depend on each dog’s ability to swallow.
A 2017 study showed some improvement in dogs with idiopathic/congenital megaesophagus when treated with sildenafil (Viagra). More studies need to be conducted to determine if this is a viable treatment option.
Megaesophagus is a lifetime condition, and any dog born with it must be closely watched for signs of aspiration pneumonia through their life.
Vascular Ring Anomalies
An important type of megaesophagus to mention that is both congenital and secondary is due to a vascular ring anomaly. In some breeds of dogs, particularly German Shepherds, an abnormal blood vessel can persist instead of regressing during development. The most common type is a persistent right aortic arch (PRAA). When a dog is born, that extra blood vessel causes constriction as the esophagus passes through the chest. In front of the vessel, the esophagus is dilated. As a puppy starts to eat dog food, it becomes trapped in the area, dilating the esophagus.
This is a fixable condition with surgery. However, after surgical repair, hypomotility may persist due to esophageal damage. Rapid diagnosis and treatment are essential to a good outcome. Any puppy that develops regurgitation at weaning should be immediately evaluated. Radiographs (x-rays) with and without contrast can be done to diagnose this condition. If a persistent vascular ring anomaly is diagnosed, surgery can be done to snip the extra vessel. This is generally conducted by a board-certified surgeon, but there are general practitioners who have performed this surgery as well.
Secondary Megaesophagus
The list of underlying causes for acquired megaesophagus is extremely long and includes muscle diseases like polymyositis, infectious disease such as tetanus, Addison’s disease, cancer, myasthenia gravis, toxins including lead and thallium, and trauma.
As with primary, there is no surgical correction for this. The underlying disease must be identified and treated. In some cases, this will significantly improve the megaesophagus, but due to the stretching, it does not always return to normal size and motility. As a result, megaesophagus may persist, leading to episodes of aspiration pneumonia.
One of the most common causes in older dogs is myasthenia gravis. This is a systemic, autoimmune illness in which the body’s immune system destroys important receptors in nerve endings. It results in generalized weakness, particularly worse after exercise. There is a medication to treat MG, and it can improve the motility of the esophagus.
Ruling out other causes can take an exhaustive list of diagnostics, so be patient while your veterinarian examines possible underlying causes. By keeping close tabs on your dog’s health and providing your veterinarian with a thorough history, the etiology of megaesophagus in dogs can often be discovered.
Published in the March 2019 issue of Whole Dog Journal was an article headlined, “Reporting Dogs’ Adverse Reactions is Your Duty.” In the article, longtime WDJ contributor Barbara Dobbins discussed the various reasons that dog owners and veterinarians should report any sort of adverse event or negative side effects they observe in their dogs or their clients’ dogs to the agency that provides oversight of whatever substance they think has caused harm.
Dobbins also provided instruction on and links for sending adverse event reports to the appropriate agencies; for example, animal drugs are regulated by the Food & Drug Administration’s Center for Veterinary Medicine (FDA CVM); topical pesticides are monitored by the Environmental Protection Agency (EPA); animal vaccines are regulated by the U.S. Department of Agriculture Center for Veterinary Biologics (USDA CVB).
We complained about one thing in that article – that the CVM’s cumulative database of adverse drug event (ADE) summaries offers only reports that were collected by the agency from 1987 through April 30, 2013. More recent reports have been collected electronically – and ironically, these more technologically modern reports have not been made available to the interested public, except through a Freedom of Information Act (FOIA) request.
The problem, as it was explained on the CVM’s website, was that the project of collating the (old) paper reports with the newer, electronically submitted reports was not complete. A note on the CVM website stated, “We anticipate having updated adverse event information available in late 2017 or early 2018.” (But the note, and not the updated adverse event reports, was still present on the website in January 2019!)
On April 3, 2019, the FDA issued a press release, announcing that it is making the adverse event reports related to animal drugs and medical devices used in animals available online – including all the reports going back some 30 years. The reports “will be available electronically onopenFDA.gov, an agency-run digital platform used by researchers, statisticians and other academics to access large, valuable public health datasets collected by the FDA.”
Hurray! The project is complete! This giant new step in transparency makes it possible for a dog owner or veterinarian to research what sorts of adverse effects to a certain drug (for example) have been experienced by dogs, and how many dogs have been affected in those ways! Wow! Cool!
But before we celebrate our new ability to check out the past ADEs, we will have to master some new and tricky (although certainly not impossible) application programming interfaces (APIs).
What the Heck is An API?
According to Wikipedia: “In computer programming, an application programming interface (API) is a set of subroutine definitions, communication protocols, and tools for building software. In general terms, it is a set of clearly defined methods of communication among various components.”
The computer programmers among our readers may just be as happy with this news as my dog Woody with his Planet Dog Squeak ball. Alas, I am not a computer programmer, and my initial excitement over the FDA news release has been thoroughly squashed by the hour or so I spent trying to learn about APIs and how to construct queries and, oh, by the way, when doing so, please note that the system makes use of British English spellings of words like “diarrhoea.”
My squashing, I hope, is temporary. I’m sure I know someone who can walk me through and past this technological challenge – perhaps to a point where I could explain to others how to access all of this valuable information on animal drugs. If you think that person might be you, take a look at the launch site, and get back to me?
Usually humping is associated with male dogs, but humping is also very common amongst female dogs. Some girls will hump toys or other objects, some hump air, others hump other dogs or even people. To learn more about humping, why girls do it, and how to keep your female dog from humping, we talk with Certified Professional Dog Trainer and Chair of The Association of Professional Dog Trainers Nick Hof, CPDT-KA, CBCC-KA, KPA-CTP, CSAT, to answer some of your most commonly asked questions about female dogs and humping.
Why Do Female Dogs Hump?
Hof advised that dog guardians shouldn’t panic. “Although it may be a bit embarrassing, humping is a normal dog behavior. You do not need to demonize it nor glorify it.” People get uncomfortable with dogs humping usually because they are under the impression that it is either a sexual behavior or connected to dominance. However, Hof explained that humping is usually a result of a heightened arousal state, but that doesn’t mean it is necessarily sexual. He explained that when female dogs hump it may also be a stress response.
Hof not only has professional experience with female dogs humping, but also personal experience at home: “I had two female dogs that would hump each other any time I had a guest over due to the heightened arousal level; a good outlet for them was humping one another.”
Does Spaying Stop Female Dog Mounting?
It is generally assumed that neutering a male dog will stop him from humping. That isn’t always the case – many male dogs will continue to hump post-neutering if that was a behavior they engaged in before the procedure.
When it comes to female dogs, spaying doesn’t generally have much impact on their humping behavior either. Girls who hump before spaying are likely to continue humping after spaying because it isn’t related to hormones. “I often see female dog humping as more related to arousal state or environmental stressors, neither of which would be changed by a spaying,” explains Hof.
Hump Toys for Female Dogs
Object-mounting is a common behavior with female dogs. “When we are trying to determine if a behavior will be reinforced, we try to look at what is encouraging or maintaining that behavior. Often humping may begin based on environmental conditions or stimuli [such as guests in the house], but if that results in, for example, laughter at the dog humping, some dogs find that reinforcing and that may be encouraged.”
So, if your female dog is humping objects like pillows, toys or furniture, the more you direct attention toward her, the more she may continue the behavior. Pat Miller offers advice on how to train your dog away from mounting behavior in this Whole Dog Journal article.
If your dog’s humping doesn’t bother you, letting her use one (or any) of her dog toys as a personal mounting object is acceptable. Toys are a safe outlet for humping behavior, and if it does not offend any nearby witnesses, allowing your dog to do this without reinforcing her is unlikely to create additional behavioral problems.
What Should You Do to Stop Female Mounting Behavior?
Dog humping isn’t inherently concerning behavior. It is very natural for dogs. The only times humping is a problem are when it makes you uncomfortable and when it makes the object of the humping (a guest or another dog) uncomfortable. In those cases, Hof suggests that, “it would be best to try and redirect the dog’s attention. This could be done by just attempting to interrupt the behavior or trying to redirect the dog’s focus by asking for a sit or other behavior.”
Nick Hof also advises that if you know your dog is prone to humping in certain conditions like when guests come over, it’s best to take steps to prevent it by redirecting your dog before she starts the humping. It’s all about creating situations where your dog is going to be successful.
“A great option is always to focus on what you would like your dogs to do [instead of the unwanted behavior]. For example, they can’t hump while also practicing a down-stay on their bed. Help show your dog what you want from them as opposed to telling them to stop,” suggests Hof.
Isn’t It Best to Prevent Dogs from Humping Altogether?
Again, there isn’t anything wrong with humping unless it makes you or the object of affection uncomfortable. If you want your dog to stop humping, then Hof suggests the best thing to do is deny her the opportunity to start.
“It is always a good idea to, at a minimum, prevent and manage behavior you don’t want your dog to rehearse because otherwise they become more well-practiced.” Hof continues, “In my experience, since female dog humping tends to be more linked to arousal and stress, it is best to look at the context of the situations that the behavior presents itself in.” Knowing the situations where your dog is prone to humping means you can give her something else to do at the times when the behavior is usually triggered.
iStock / Getty Images Plus/ blamb
What if My Female Dog Humps Other Dogs?
Some female dogs hump other dogs, and this isn’t always bad. However, some dogs will react very negatively. Hof believes this comes down to a consent issue between the dogs: “If the dog or person your dog humps does not appear to be okay with the act, it’s a good idea to discourage and redirect your dog’s humping. If they don’t seem to care and neither do you, it comes down to personal preference.”
With that in mind, many dogs do really take offense to being humped, so if you take your dog to dog parks or other meetups with dogs, it’s a good idea to watch her and ensure she doesn’t start humping other dogs – which can lead to a fight.
How to Stop A Female Dog from Humping People
Hof advises that the best thing you can do is, “Management. Management. Management.” He suggests that if your dog likes to hump and you cannot allow it, it’s a great idea to keep your dog leashed at times she’s likely to engage in humping, even in the house. “If your dog is on-leash, you have much more control over their actions,” Hof reminds us. Focus your attention on teaching and encouraging your dog to do what you want her to do instead of having to redirect or correct the humping once it has started.
If you are struggling with your female dog’s humping behavior, schedule a consultation with a positive reinforcement-based dog trainer who can support you with gaining a greater understanding of what is triggering or reinforcing the humping behavior with your dog.
Sassafras Lowrey is an award-winning author and Certified Trick Dog Instructor. Sassafras’ forthcoming books include, Tricks IN THE CITY: For Daring Dogs and the Humans That Love Them, Healing/Heeling, and Bedtime Stories for Rescue Dogs: William To the Rescue.
While some essential oils can benefit dogs, others are extremely dangerous – especially when used in concentrated forms. Tea tree oil demands extra caution around dogs, cats and small children. Although exposure to any essential oil is generally most concentrated when it directly contacts skin, tea tree oil diffusers and liquid potpourri present specific health concerns to dogs. These items release essential oils like tea tree continually into the air, risking exposure by inhalation.
So Tea Tree Oil is Completely Dangerous to Dogs?
Some dogs are safely treated topically with tea tree oil for skin conditions. The toxin found in tea tree oil is metabolized by the liver, making diluted tea tree oil safe for topical use on most dogs – but always consult your veterinarian before exposing your dog to it. Cats, on the other hand, have less of the liver enzyme necessary to metabolizing tea tree and should never be exposed to the oil in any form. (Birds are especially sensitive and should never be exposed to essential oils; these toxic effects extendeven to fish, reptiles and rodents.)
According to a recent report published in the Journal of the American Veterinary Medical Association, there have been numerous instances of tea tree oil toxicity in dogs and cats from a decade of data collected from the ASPCA Animal Poison Control Center.
Getty Images / Amy_Lv
Owners should always exercise caution when using 100 percent essential oils either on themselves or in the home. Essential oils should never be left out or open when there are pets in the house. If used on dogs topically, essential oils must be diluted to be safe.
If you choose to diffuse essential oils with dogs in the house, do so only for short periods of time and in a room where the dogs do not have direct exposure. Be sure to keep the oils and diffusers out of reach even when they’re not in use. Open windows when you’re done and take your dog outside frequently during and after diffusing tea tree oil. Never leave your dog in the house unattended with an essential oil diffuser on. Different dogs may have different reactions to inhaling any concentrated oil. Monitor your dog closely.
Topical Tea Tree Oil Uses for Dogs
Because tea tree oil is effective in treating certain human skin conditions, some dog owners have used it to treat similar maladies in their dogs. Skin allergies and hot spots are two of the more common conditions, as are ear infections and yeast infections. Tea tree oil shampoo for dogs is believed to provide a variety of benefits for coat and skin health, as well.
However, you should never apply essential oils to your dog without the advice and direction of your veterinarian, and be sure to inform your veterinarian of any other pets living in your home. It’s important to purchase a high quality essential oil and not look for a bargain, which will likely be an inferior (and perhaps dangerous) product.
Signs of essential-oil poisoning include vomiting, diarrhea, drooling, depression, lethargy, weakness, wobbliness, tremors and abnormal behavior. There’s a direct correlation between the severity of illness and the dog’s weight and age. The smaller and younger a dog is, the sicker they are likely to get.The same applies to dogs with liver disease.
Getty Images / Dewin’ Indew
Essential Oils Most Toxic to Dogs
Tea tree oil
Citrus
Oil of cinnamon
Peppermint
Pennyroyal oil
Sweet birch
Ylang ylang
Wintergreen
Pine oils
If you suspect that your dog may have ingested or inhaled a toxic essential oil, promptly call your veterinarian, a veterinary emergency room or the ASPCA Animal Poison Control Center at 888-426-4435.
Some people who have read the following post objected to its original focus on atypeof dog. The intent of this post is to ask the question, “What can we do to reduce the hazard of dangerous dogs in our communities?” As stated in the post, we do not support breed-specific legislation, and know only too well that breed identification (even through DNA tests) does absolutely nothing to identify dangerous dogs. So, to be more clear, we have removed any language that refers to breed or even type. The issue remains: What can we do to increase the safety of our dogs, children, elders, and selves from dangerous dogs of ANY breed and type – or even size?
For example, a friend wrote to me privately and said she wishes that the individuals who run rescue groups had to bear financial or legal responsibility for the dogs they adopt out for at least some period of time. Too many rescue organizations, in her opinion (and mine), go too far to save dogs who have worrisome bite histories; if the principals at these organizations had to bear more of the risk of placing a known biter back into society, perhaps they would be more stringent about the dogs they attempt to rehabilitate and place. It could be similar to drunk-driving laws that place some responsibility on bartenders who overserve customers, who then drive drunk and cause harm to others.
Personally, I am focused on the original oversupply of particularly large and/or particularly strong dogs. Their over-representation in shelters, rescues, and in foster homes who are holding them for shelters and rescues, indicates that there are far too many of them being produced, and not enough appropriate homes for them – with people who have particularly escape-proof homes or properties, the physical strength to control them, and the education/skill/experience to properly socialize, manage, and train them. There is a thriving black market for dogs who are large and/or powerful, with tens of thousands of puppies being produced and sold and dumped at shelters in higher percentages than any other type of dogs (save, perhaps, Chihuahua-mixes). What can make it more difficult for backyard breeders to churn out badly bred, poorly socialized, stressed big/strong dogs, many of whom end up in shelters? These are the questions we’re asking.
There are a few helpful suggestions in the comments below. Helene G. mentioned that New York state has good “dangerous dog” legislation. I’m going to take a look at that, and will run an update. What else can we do to keep ourselves and our loved ones safe from dangerous dogs in the possession of people who are not wiling or able to control them?
Two weeks ago, my husband and I went hiking on Table Mountain, a volcanic plateau that looms on our northern horizon. The open space area is managed by the California Department of Fish & Wildlife, although it’s adjacent to privately owned property. Beef cattle roam over the entire plateau, on both public and private lands (cattle ranchers lease grazing rights on the public land from the state). It’s best known as a springtime destination for its vast array of tiny wildflowers and dramatic waterfalls.
I brought just one dog, my three-year-old mixed-breed, Woody. We planned a long hike, and I didn’t want to subject my senior dog to a long day on unknown terrain. The area has few trails – and none, oddly enough, go directly to the biggest, most dramatic waterfall; one has to sort of wander across the plateau in a general direction, until you find the appropriate stream and follow it to the cliff it goes over.
For much of the past few decades, access to the land was informal. Private landowners pretty much looked the other way when hikers came to gaze at the waterfalls in awe, or traipse around the wildflowers. But a couple of years ago, the area was added to a list of state lands that would require a small admission fee. One can either pay for a day pass (less than $5 per person), or purchase a year-round pass that confers access to a number of state parks and trails (less than $26), or, show a hunting or fishing license. Some portable toilets were added to the parking lot, and a sign was erected that posted a few rules.
One of those rules was that dogs should be on leash.
Keep in mind that locals have been taking their dogs to this area for decades and letting them run off leash. And they still are. Even me.
However: I practice off-leash behavior with my dogs literally every day. If they show any sign of being unable to heed my cues to stay near me, or sit instantly when I call for them to do so, they go back on leash immediately. I keep my dogs on leash when I am near any other humans, and especially near any other humans with dogs.
So there we were, my husband, Woody, and I, crossing a wide-open vista, in search of the biggest waterfall. A few cattle grazed nearby. As he always does, Woody kept his eye on them, and kept close to me. He’s not sure about cattle, but he knows not to go near them. As we walked, I noticed one young steer grazing apart from the rest, just to our left, and some mamas and one giant bull to our right. I called to my husband, who was a bit ahead of me, to veer to the left and not get between the youngster and the rest of his herd, lest the bull or the mamas get concerned. (Range cattle, who have to cope with coyotes and mountain lions on a regular basis, may well give chase en mass to an unwary dog.)
Just as we veered left, I noticed another young steer, all by itself, a few hundred yards off to our far left, running fast (well, as fast as a 400-pound steer can run) toward us. I glanced at the mama cows and especially at the bull, to see if they were alarmed or taking defensive action. They were watching but hadn’t moved. I called Woody even closer, to my side, and gave him some treats from my pouch of training treats. And that’s when I noticed that the young steer wasn’t just running for fun, or because he had been left behind; close on his heels was a brownish-gray large dog, chasing him with an intent look. Farther off, there was a group of people, with one man chasing and yelling at the dog, to no avail.
And the dog was rapidly gaining on the steer.
A few days prior, I had watched a video taken by someone in Detroit who was one of several people who spent the better part of five long minutes trying to rescue a postal worker from a large dog who, as the video started, had the mail carrier on the ground and was biting his leg. Don’t watch the video unless you are tough; it’s pretty graphic. The man is injured, though ultimately saved, and the dog is badly injured before finally letting go of the man. I watched it several times, and discussed it with a number of other people who watched it, as an educational opportunity. What’s the best way to stop a strong dog in the middle of an attack? The only thing that stopped this dog for long enough for the postal worker to get away was being choked, almost to death, by a leash or rope wrapped around his neck. (And the minute the leash was dropped, though staggering with oxygen deprivation and badly injured, the over-stimulated dog was still looking for someone, anyone, to go after.)
So that was very much in my head. I could see that, within seconds, the dog was going to catch up to and grab onto the steer’s hind leg, or worse, throat. I saw myself trying to stop the attack and control the dog. Having grown up in cattle country, I also saw the possibility that the range bull (who was about 150 feet to my right) would launch into action and come after the dog. I saw my dog Woody getting hurt by either the out-of-control, over-stimulated dog, or the bull.
So I flew into action. I yelled at my husband, “Keep your eye on the bull!” and started running directly toward the steer and the dog, yelling in my deepest, meanest, most out-of-control, angry voice and waving my arms like a crazy person. “NO! BAD! GET OUT OF HERE! BAD DOG! NO! YOU GET!”
Faced with this, the steer veered off, further to my right. And although at this point, the dog was no more than 20 feet from the steer’s hind feet, he was momentarily distracted by my attack. He glanced toward me, and slowed a bit, a bit less intent. As I continued to yell and advance toward him, now miming that I was picking up rocks and throwing them at him, he slowed further and then came to an uncertain stop about 100 feet to my left. I continued to yell, “YOU GET BACK. BAD DOG! GO!” And then suddenly his thinking brain kicked in again, taking control back from his reptile brain and predatory instincts. He heard his owner (still about 400 feet away) yelling for him, and turned and ran back toward his person. With my heart pounding and hands shaking from the adrenaline coursing through my body, I also yelled furiously toward the man, “LEASH!” (I didn’t trust myself to say more, I was poisoned with anger.) I looked back toward the bull and the rest of the herd and they were still stationary; the steer ran to his mama.
And then I looked at Woody – who was cowering behind my husband, scared to death, shaking so hard he could barely stand. I said, “Oh Woody! It’s okay! Come here!” – and he wouldn’t come to me!
My heart just broke. I dropped to my knees and, also shaking, patted my lap. “Oh baby puppy, come here! It’s okay! YOU are not in trouble! You are a good, good, dog!” I opened my treat pouch and, tears running down my face, dumped out a huge handful of treats. He came to me then, still shaking with fear. I stroked and petted him as he licked his lips nervously, and we sat there for a few minutes, both of us recovering from the flood of stress chemicals in our bloodstream. I was so upset – at the person who had his dog off-leash and without control, and at myself for scaring the crap out of my own dog. But I also felt I had done the right thing; there is not a doubt in my mind that without my intervention, that dog was going to attack that steer and it was going to be all bad.
For the rest of our hike, I kept reassuring Woody that he was a very, very good dog, and we never came within sight of the other party of people (or their dog) again. By the end of the hike, Woody’s confidence in me seemed restored. I’ve made many deposits in our relationship account, and though that was a major withdrawal of funds, at the end of the day the balance was still positive, thank goodness. Had he been a more fearful dog, or our relationship not so secure, my frightening behavior might have bankrupted us irreversibly.
The second event happened two days ago and is more tragic. I was working at my desk, at my office/house in town, when someone knocked urgently on the front door. I answered the door and saw a teenaged boy who lives across the street and one house over. He said, “There’s a dog that got mauled and the owner needs your help!” I was like, “What? Who?” But I grabbed a leash – again, thinking of that dog in Detroit, who had to be choked almost to death to be stopped – and followed him at a run down the sidewalk. There was a group of people gathered on the sidewalk about six houses down, with one woman kneeling and a dog on the ground. The woman on the ground was my neighbor from directly across the street. She has an ancient, blind, deaf old man of a Beagle, Brando, whom she walks very slowly every day. Brando was lying on the ground in front of her, wearing his vest harness and leash but covered with mud and spit and blood. As I approached, I saw his chest expand and then fall – and he didn’t move again. We all gasped as we realized he had taken his last breath.
I put my arm around my neighbor, who was stunned, crying, in shock, and also covered with mud. “What happened?” I asked her. She said, “There were three dogs… they attacked him.” I said, as much to the other neighbors standing there in shock as to her, “Where are the dogs? How far? Where are they?” Everyone started to answer at once. “Around the corner… they are still loose… we saw them…”
Because I volunteer at my local shelter, I have the number (the same as for our animal control officers) on speed dial. I said, “I’m going to call animal control, and get my car.” I asked another woman standing there to stay with my neighbor. I pulled my mobile phone from my back pocket as I trotted home to get my car. When the shelter staffer answered, recognizing his voice, I said, “Dave, we need an officer here, fast. Some loose dogs just killed my neighbor’s old Beagle as she walked him down the street.” He said he would send officers as soon as possible.
I drove back down to the knot of people. One of the people is a guy I have seen walking his senior (though not nearly as senior as Brando) Beagle around the neighborhood. He said, “Those dogs are still loose!” I said, “An officer is on the way, but let’s make sure someone knows where the dogs are – can you keep your eyes on them, or where they go?” He took off up the street, and a minute later, I saw an animal control truck pause at the corner, and then turn up the side street toward where the man had gone.
Together, my neighbor and I lifted her dead dog’s limp, sodden body and placed him onto the back seat of my car. I said, “Honey, I know this is all very sudden, but we could take him to the shelter and arrange for him to be cremated, if you would like.” She nodded and said yes, she’d like that, but she wanted to go home for a minute and check on her other dog, a middle-aged Lab she had adopted from our shelter just a few months ago. I told her I would wait with Brando, and took the opportunity to call the shelter again and let them know I would be bringing my neighbor and her dog; could someone be ready to help her arrange for the dog’s cremation?
We were at the shelter, and she was talking to a shelter staffer about cremation options, when the officers who had been dispatched to the scene returned to the shelter, shaking their heads. The other neighbor who owns a Beagle had seen and spoken to the woman who owned the three dogs who attacked Brando. For reasons of his own, he had apparently told her angrily that animal control was on the way and they were going to seize her dogs. By the time the officers got there, she had put her dogs in a truck and fled the scene.
We just stood there, stunned. There would be no justice for Brando’s murder today.
My neighbor recounted for the officers what happened. She was walking Brando on leash, at his usual slow pace, when a collarless, unaccompanied black Lab-mix approached them. The dog was sniffing Brando and everything was fine, when a woman opened a door to her apartment and started yelling at the dog to come – and two other dogs got past her and ran straight for Brando, instantly attacking the old dog. One was a large brown dog, and the other dog was black – my neighbor thought the second attacking dog was a Lab-type, but it was all a muddle. She said the brown dog had Brando by the neck and was shaking him, and the other dog grabbed Brando by the face, and neither would let go. She didn’t think the first dog who had been sniffing Brando was involved but couldn’t be sure, it was all a blur. She said she and the other woman were both yelling and trying to stop the dogs, and as soon as the dogs let go of Brando, she picked him up and tried to carry him home, but she stopped on the sidewalk where I first saw her, as they were both gasping for breath. And he took his last breath when I came upon them.
The officers promised that they would haunt the woman’s apartment and do whatever they could – but that she might “disappear” the dogs, in which case there would be little they could do, from an enforcement angle. There was no record of licensed dogs at that address, so if they could find the woman and any dogs at the address, they would require her to show proof of rabies vaccination and licenses; if she didn’t comply there would be some teeth in what they could do, but if she did comply, that would likely be the end of it. They were frustrated and upset, and sympathetic to my neighbor, just as I am. I can’t imagine how upset I would be if it was my beloved senior dog who met his end in such a traumatic, horrible way.
I have no helpful thoughts. I am horrified by the ubiquitous presence of these uncontrolled, seemingly untrained, aggressive, powerful, and powerfully focused dogs. Why are there so many of them – in my community and most everywhere else in this country? Our shelters are full of them and it seems like many of the people that own them have no ability to control or contain them. Against their stated policies, Craigslist and Facebook are full of ads for their puppies for sale.
And yet, there are also many powerful, but sweet, reliably friendly dogs out there, too. My one and only foster-failure pit-mix, the gentle and easily frightened Woody – one of nine puppies who washed up onto the shores of my local shelter three years ago – is a delight to own and train. My Facebook feed is loaded with pleas from fellow foster-providers who have taken in homeless large, powerful dogs who are affectionate with all humans and other animals and easy to handle, but no one seems to want to own those! The dangerous ones make it terribly hard to find good homes for these nice ones. Sometimes it seems like the only people who want these dogs are the people who really shouldn’t have them!
Aggression in dogs, no matter the breed or type, is always a concern. But it is a special concern in dogs who are especially strong and as focused (when in predatory, fight, or aroused mode) as many of these large breeds can be. If you doubt this for one minute, go ahead and watch that video linked at the beginning of this post. But don’t let it poison you against all of these dogs; there are terrific ones out there, who wouldn’t dream of biting, not to save their lives.
Sometimes, I soak my dogs’ dry food in warm water for 15 or 20 minutes before I feed them. I do this for a couple of reasons. My older dog has had a few dental extractions, and doesn’t chew up his food as well as he used to – not that any dog grinds up much of the kibble he or she eats; unlike ours, canine teeth are not much for grinding. Mostly, a few of the kibbles get crunched, and more likely get swallowed intact. My younger dog is prone to eating way too fast – just bolting down all his food whole in less than a minute (unless I put it in a slow feeder or snuffle mat) – and I am guessing that it will put less of a strain on his digestive system if the food arrives even slightly pre-moistened.
And I know that feeding both of them soaked food makes them feel more full. Dry foods are so nutrient-dense, that the volume of the amount of food that is calorically appropriate for their weight might not come close to filling up their tummies. If their meal is full of water, it definitely increases satiety – that sensation of fullness. They quit walking around the kitchen looking unsatisfied after their meals when their food is soaked.
If you’ve ever soaked your dog’s food, you’re aware of how much dry dog food expands when immersed in water. It’s a little horrifying, actually, to realize how much more space a certain amount of food will require in a dog’s stomach and gut once the dog’s digestive juices hydrate the individual kibbles. It nearly doubles in volume. The kibbles are like little sponges – some more than others. I’ve noticed when soaking food for various foster puppies that some kibble is more resistant to soaking than others.
Neither of my dogs are reluctant or picky eaters, but adding water can definitely increase the palatability of dry food for some dogs.
However, one shouldn’t moisten food and leave it sitting out at room temperature for very long – I would start being concerned about bacterial growth in moistened food that had been left out at room temperature for more than an hour.
Many people believe that feeding soaked food will help prevent bloat. I’m not sure there’s ever been a study that looked at just that, but it would make sense to me. I’m super cautious about exercise for a couple of hours after feeding, too, for the same reason.
Out of curiosity: How many of you moisten or soak your dog’s dry food?
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Many years ago, my parents owned a German Shepherd Dog named Kale. (It wasn’t pronounced like today’s trendy vegetable; rather, the dog was named in dubious honor of a Hawaiian tough-guy former boyfriend of my oldest sister, and it was pronounced exactly like “Collie.” That confused everyone, calling our German Shepherd “Collie!”, but I digress.)
Kale (the dog, not the Hawaiian boyfriend) was a confirmed and completely unrepentant bee-eater. He was also completely untrained; my stay-at-home mom bought him from a backyard breeder not long after I, the youngest child and last one to leave home, left the “nest.” She needed another young being in the house to take care of – but she sort of forgot that I was the only one in the family who ever trained the family dogs. Kale grew up with zero direction, and like most GSDs, responded to the guidance vacuum by finding odd things to do with his time. Like hunt for bees.
Happily for Kale, there were almost always wasps flying around and under the deck that surrounded my parent’s above-ground pool. The big, underemployed dog made it his nearly full-time hobby to patrol the deck for any flying insects, but especially any wasps that might try to sneak past him and build a papery nest under the deck. Also happily for Kale, he wasn’t highly allergic to the many stings he suffered in the pursuit of his hobby. Oh, he often had a lumpy, swollen face, but we all sort of got used to it.
There was one benefit of his bee-obsession. Because he had no recall to speak of, my parents learned a trick to get his attention or to get him to come to them: They would mimic the buzzing of a bee, and he’d come running. Poor Kale! He never quite figured out that they were faking; he was enough of a good-hearted optimist that he would run to them and start looking for a bee. And given that my parents lived at that time in Petaluma, California, surrounded by dairy and beef cattle ranches and chicken farms, Kale’s search was almost always rewarded with some sort of tangy flying insect.
In all seriousness, however, many dogs are not as lucky as Kale; some suffer supremely uncomfortable swelling, and some even die from anaphylactic shock after being stung by bees or wasps. For this reason, we’re presenting you with not one but two articles that concern bees. The first, written by North Carolina veterinarian Catherine Carr Ashe, explains what you should know about the treating a dog who gets stung. And our Training Editor, Maryland dog trainer Pat Miller, explains how to teach bee-chasing dogs to leave bees alone, and how to teach dogs who panic at the sound of bees to just leave calmly.
At just eight months old, Sirius, my Newfoundland, partially tore the cranial cruciate ligament (CrCL) in her right knee. It was a shock to me, as she came from an excellent breeder, and because my partner and I had been very cautious about our puppy’s activity levels and kept her from doing anything even remotely high-impact.
Because of her age and the fact that her growth plates were not yet closed, we decided the best option for the time being was conservative management, rather than surgery. Sirius healed well for a time and was medically cleared to return to low-impact sport training.
Sassafras Lowrey
Multiple Cruciate Ligament Tears in One Dog
This past summer, at 20 months old, Sirius began limping again. Just as before, there was no precipitating incident, and we were being assiduous in maintaining her low-impact lifestyle; we always lifted her in and out of cars, etc. Yet diagnostics showed that she had – again – partially torn her right cranial cruciate ligament and significantly torn her left CrCL.
This time, thankfully, her growth plates were closed, making Sirius an ideal candidate for surgery. We began meeting with and interviewing veterinary surgeons.
At the time, we were living in a multi-story Brooklyn townhouse. For some time, my partner and I had been talking about a move to the West Coast; suddenly, this seemed like the perfect time to make the move. We realized that if we moved first and Sirius had the surgery there, she could have an easier rehabilitation than would be possible in a home with as many stairs as our townhouse. That’s how we came to spend a couple of weeks sleeping on an air mattress and living downstairs (since Sirius couldn’t do stairs) as we packed up our life and put our house on the market. Then we drove cross-country with our three dogs (and three cats!) to our new single-story home in Portland, Oregon.
Sirius’ TPLO Surgery Plan
As we learned in our independent research and from meeting with multiple veterinary surgeons, the TPLO surgery has become the gold-standard treatment for this kind of knee injury, especially in very large, strong, young, athletic dogs. While waiting for Sirius’ growth plates to close, we saw firsthand how conservative management worked – and then didn’t. We were looking for a treatment option that gave Sirius the best chance at the kind of fun and normal life she deserved, one that would allow her to return to the activities and sports training that she loved.
We had a surgical consultation scheduled for right after we arrived in Portland, and Sirius was scheduled to go in for surgery a few days later.
Sassafras Lowrey
Sirius had bilateral TPLO – both knees operated on at the same time. It was determined at the time of surgery that Sirius had one fully torn knee (left) and one partially torn knee (right, with scar tissue from the months of conservative management we had to do when she was too young for surgery).
In addition, the surgeon recommended one more procedure: a meniscus release in both knees. There are actually two menisci in each knee, and in some cases, they can become “caught” on protrusions from the tibia within the knee joint, causing further pain and injury. In the meniscus-release procedure, some connective tissue is severed to divide the menisci and ensure that they can no longer get caught. The procedure decreases the chances of a subsequent meniscal tear, so we told the surgeon to go ahead.
TPLO Surgery Recovery and Rehab for Dogs
I have to say – recovery was no joke. My partner and I both work from home, so we were able to arrange our schedules in order to provide Sirius with around-the-clock care and supervision when she came home from the hospital; this started the day after surgery. It was incredible to see how she was bearing weight already! We didn’t leave Sirius alone for a minute until the staples came out, 16 days after surgery.
The day after the staples were removed, we began weekly visits with a veterinary physical therapist. Sirius’ treatments included laser therapy, time on an underwater treadmill, and guided structured exercise. The latter was essential, as it also gave us a tailored daily exercise plan to work on at home, as well as a schedule for daily walks that increased in length and intensity under the guidance of her therapist.
Sirius had her final surgical recheck at eight weeks post-surgery and had new x-rays taken. Her knees had healed beautifully. In total, we had done eight sessions with a physical therapist before Sirius graduated and was fully cleared to resume all normal activities and all sport training.
Prior to her knee injuries, Sirius was swimming regularly. To be extra safe, we booked a consultation with a veterinary swim specialist at a dog pool/swim center, to ensure that she was still a strong and collected swimmer. It was determined that surgery had no impact on her swim style and that it was safe for her to resume regular swimming and begin water work training next season.
At nine weeks post-surgery, Sirius returned to low-impact Rally obedience training; at 13 weeks post-surgery she competed in her first Rally trial.
Today, at not quite five months post-surgery, Sirius’ quality of life is beyond what I could have imagined. She completed her Champion Trick Dog Title, has returned to Rally training, enjoys hiking and visiting the beach, walks for more than an hour a day, runs in the backyard with my other dogs, swims in rivers, and basically is loving life in the Pacific Northwest. TPLO surgery gave back my young, exuberant, athletic dog the ability to live life to its fullest.
Sassafras Lowrey
Sassafras Lowrey is an award-winning author and Certified Trick Dog Instructor. Sassafras’ forthcoming books include Tricks in the City: For Daring Dogs and the Humans That Love Them, Healing/Heeling, and Bedtime Stories for Rescue Dogs: William to the Rescue.
When your dog comes in limping from a play session, a lot of thoughts go through your head. Is a trip to the vet needed? What can I give to help? How did this happen?!
Last month, we covered one of the most common orthopedic injuries in dogs – the cranial cruciate ligament tear. This month, we’re going to talk about how to fix it.
The 4 Most Common Options for Treating Dogs’ Cruciate Ligaments
The most common options discussed after the diagnosis of a cruciate ligament tear are:
Braces
Lateral suture
Tibial plateau leveling osteotomy (TPLO surgery)
Tibial tuberosity advancement (TTA surgery)
There are other procedures out there, but there’s a reason these are the four most common treatments offered.
The truth is, we do not have a perfect solution. Research is constantly evolving and we are still in search of the perfect fix. In humans, a synthetic or biologic ligament is placed where the damaged ligament used to sit. This was tried in dogs, but the outcomes were never good. The replacement ligaments were just not well tolerated. Consequently, something different had to be done.
Braces for Ligament Injuries
Bracing the stifle is no small task. It’s an incredibly dynamic joint that provides spring, shock absorption, and the ability to turn on a dime. The key to a brace is stability and fit.
Braces for a cruciate tear may cost $1,000 or more. There are inexpensive options, but bargains are not a great idea when it comes to your dog’s lifelong comfort.
Ideally, a knee brace is custom-fit for your dog, sometimes involving a mold made of his joint. This ensures good fit and appropriate flex. Remember, the knee still needs to bend to be useful! A brace cannot provide complete stability, but it can alleviate some of the pain from a joint that is moving improperly.
The two canine-brace companies most often recommended by vets are OrthoPets and Hero Braces. It’s important to remember that a brace does not fix a cruciate tear, it simply helps to stabilize the knee. Success depends on selecting the right brace, a good physical therapy program, and a commitment to refitting as needed.
The Lateral Suture Procedure
The lateral suture procedure (also known as the extracapsular repair) is the closest thing to the repair done in humans. This does not make it the best choice. This is one of the first surgeries developed when it was determined that repairing the ligament directly was not a good option.
In this procedure, a heavy gauge suture is placed outside of the knee joint in the same direction that the cranial cruciate ligament used to run. A hole is drilled through the front of the tibia (the lower leg bone). The suture is passed through this hole and then up and around a small bone, called a fabella, behind the femur (the upper leg bone). The creates a loop that is similar in location and direction to the cranial cruciate ligament, but outside of the joint.
This is an important distinction. Because this surgery does not involve opening the joint, the meniscus (the cartilage cushion that provides shock absorption in a joint) is not always evaluated for tears. The jury’s still out on this procedure, but most surgeons feel a torn meniscus can cause persistent pain.
Ultimately, the goal of this surgery is not to repair the cruciate ligament, but rather to direct the growth of scar tissue. Basically, the suture provides a scaffold for scar tissue to form along the same path as the torn cruciate ligament, thereby stabilizing the joint. Over time, this suture will break down. It’s not meant to last forever, just long enough for enough scar tissue to form.
This procedure is quick, relatively inexpensive (typically $1,500 to $2,000) compared to other surgical repairs, and can often be performed by your regular veterinarian. However, it’s not for every case.
If the suture breaks before sufficient scar tissue is laid down to stabilize the joint, the entire surgery becomes ineffective. If a dog is too big or too active, you can almost guarantee failure. Most veterinarians recommend this surgery only for dogs who are less than 40 pounds or dogs who are happy being couch potatoes. Having said that, finances are an important part of any veterinary decision, and this is definitely the least expensive surgical option.
TPLO and TTA Surgery
The tibial plateau leveling osteotomy (TPLO) and the tibial tuberosity advancement (TTA) procedures are both aimed at mechanically altering the joint to make the cranial cruciate ligament unnecessary. Both surgeries require the surgeon to open the joint, so the meniscus can be evaluated for tears. These are somewhat complicated surgeries and involve a complex understanding of the knee joint, but we’ll cover the basics.
In last month’s article, I described the structure of the canine stifle joint and how it differs from the human knee. The slope to the tibia is one of the biggest contributing factors to this injury. In the TPLO surgery, this slope is taken out of play. A circular cut is made in the top of the tibia and the slope is rotated into a neutral position. A plate is used to secure the bone in its new position. This creates a knee joint that closely resembles the human knee joint. Without that slope, the cranial cruciate ligament is no longer as important; the knee is stable without it. This surgery is typically performed only by boarded surgeons and costs around $4,000.
This procedure has the fastest reported return to normal activity, meaning dogs who get this surgery are able to return to a comfortable life faster than any other procedure out there. However, it’s not without drawbacks.
Aside from the cost, there is risk of failure. When a dog is too active immediately after surgery, the plate can break or move. Failure of the plate can be catastrophic. Recovery is an eight-week process, involving first crate rest, then physical therapy, and a gradual increase back to running in the yard.
Similar to the TPLO, the TTA changes the forces in the knee joint to render the cranial cruciate ligament unnecessary. In this case, a cut is made in the front of the tibia. This piece of bone is moved forward, which pulls on the patellar tendon and neutralizes the backward motion of the femur during weightbearing. This lets the dog move comfortably without an intact cruciate ligament.
In this case, a specialized device consisting of a “cage” and a “fork” is used to secure the bone in its new position. Over time, it heals fully and is very stable. If it were to fail, a TPLO procedure can still be performed.
The recovery time for these two surgeries is similar, but dogs typically take a little longer to be fully comfortable after the TTA surgery. The cost is a bit less than a TPLO, but it is also an expensive procedure – usually in the $3,000 to $3,500 range. It is typically performed only by boarded surgeons, but there are some general practitioners who are comfortable with it and have the necessary equipment.
Don’t Self-Medicate
When your dog hurts, you may tempted to look in the medicine cabinet for something to ease her pain. But there are very few over-the-counter human medications that you can safely give your dog.
Many years ago, we used aspirin for pain in dogs. However, studies have shown that the pain control offered by aspirin is pretty minimal and it has serious side effects. Aspirin increases bleeding tendencies by inhibiting platelets, a key component in clotting blood. Aspirin use also limits the options that your vet has to treat your dog’s pain because of how it interacts with other medications.
Ibuprofen should never be given to dogs as it can cause irreversible liver damage and can even be fatal. Tylenol (acetaminophen) has its place in veterinary medicine, but only under the guidance of a veterinarian because, with certain other diseases, it can be very dangerous.
If your dog is in pain, resist the urge to toss her a human pain-killer. Your veterinarian has an arsenal of medications that are safe for dogs and will work much better than what you have at home.
If Your Puppy Is a Lemon, Make Lemonade!
Shortly after our dog Agnes was born, she was considered the pick of the litter for Paws with a Cause, a local organization that trains service dogs. However, at her very first veterinary appointment at just eight weeks old, she was found to have hip dysplasia and “trick knees” – which, in her case, had her kneecaps slipping to the outside of the joint.
Because of these problems, she couldn’t be a service dog and she couldn’t be adopted to the public. She needed thousands of dollars in surgery to fix her back legs! Euthanasia was being considered for this little “lemon” of a puppy. In a lucky twist of fate, she found her way to our doorstep, just when we were looking for a new companion for our family.
Agnes underwent three major surgeries at just four months old. A local veterinary surgeon offered her services pro bono, using Agnes as a teaching case to learn a new procedure. Agnes’ pelvis and both of her knees needed corrective procedures. Fortunately, her recovery was smooth and she grew into a lovely and beloved dog.
Shortly after she turned three years old, Agnes came up lame after playing with a puppy. Due to her history, we were immediately worried that it was one of her hips, but her limp was intermittent and it didn’t seem painful when her hips were manipulated. It gradually became clear that one of her knees was the problem and she was diagnosed with a partial tear of her left cranial cruciate ligament.
For the next six weeks, Agnes was placed on strict cage rest and a physical therapy program to try to keep her injury from progressing. But three months later, when she was finally allowed to play, she immediately came up three-legged lame; she had torn her ligament completely.
We took her right away to a board-certified surgeon who assessed her knees and we came up with a plan. She underwent a TPLO procedure the very next day to repair her joint yet again. Because of Agnes’ other orthopedic problems, her young age, and her generally wild demeanor, we decided that a TPLO was the best option for a good long-term outcome. This surgery stabilized her joint and decreased her risk of arthritis down the road.
Her rehab seemed far longer than the eight weeks it actually was, especially since she felt comfortable after just a day post-surgery! But the surgery was worth every penny and the rehab was worth every minute of activity restriction. Now, two years later, she’s back to her old antics and shows no sign of lingering discomfort!
Ligament Injury Treatment Conclusions
Again, there is no perfect solution. Every single option is valid for a different circumstance. The important thing is figuring out which solution works for your dog. Older, smaller dogs who are less active often do great with a lateral suture repair! A two-year-old Lab with bad hips needs a bit more stability in the knee, so a plate repair (either the TPLO or TTA) would be a better option.
Your location might make the decision; most surgeons learn one procedure and stick with it, so both might not be offered near you. The two procedures have similar success rates and are both recommended for larger, more active dogs.
Bracing and what’s often referrred to as “conservative management” is simply not as successful as the surgical options, but when surgery is not an option, it’s better than nothing.
With time, the limp from a cruciate tear will improve without any intervention. Scar tissue will form and the joint will be useable, but the arthritis that will develop will limit the dog’s quality of life. This is not an emergency injury, but the sooner it’s addressed, the less arthritis and the better the long-term outcome.
At the risk of sounding like a broken record, talk with your veterinarian! Be up front about financial constraints, recovery concerns, and long-term goals so that you can come up with a plan that’s right for you and your four-legged friend.
Kyle Grusling, DVM, practiced emergency medicine for three years before switching to a general practice, Northland Animal Hospital in Rockford, MI.
Osteosarcoma is the most common type of bone tumor diagnosed in dogs, affecting an estimated 10,000 dogs each year in the U.S. alone. Too many owners are aware that this disease can be extremely aggressive with a poor prognosis.
In October 2018 at the Veterinary Cancer Society annual conference, researchers from the University of Missouri presented their initial findings of a clinical trial of a new patient-specific targeted treatment: a vaccine created from the dog’s own tumor that harnesses the power of the dog’s immune system to eliminate the cancer.
The team partnered with ELIAS Animal Health to evaluate ELIAS’ Cancer Immunotherapy (ECI). Fifteen privately owned dogs (not laboratory animals) with osteosarcoma were enrolled in the study. The 10 dogs who completed the therapy (consisting of the ECI vaccine and protocol) experienced extended survival times – a median of 415 days of remission. This greatly exceeds the median remission time reported for osteosarcoma patients receiving amputation and chemotherapy (about eight to 12 months). Half of the dogs who received all aspects of the therapy are still alive, without disease, well over a year and a half later.
Further, the study found the treatment to be safe and tolerable. Chemotherapy can have toxic side effects and destroy healthy cells, so it’s really exciting that “it’s the first time that dogs with osteosarcoma have experienced prolonged survival without receiving chemotherapy in a clinical trial,” says Jeffrey M. Bryan, DVM, PhD, DACVIM Oncology, professor of oncology at MU’s College of Veterinary Medicine and director of the school’s Comparative Oncology Radiobiology and Epigenetics Laboratory.
How the Bone Cancer Vaccine Works
The treatment involves a two-part protocol that takes about 60 days. Surgical removal of the patient’s tumor by a veterinarian is the first step. The cancerous tissue is sent to the ELIAS lab where a patient-specific vaccine is produced and returned to the vet. The vaccines are administered on a weekly basis to activate the dog’s immune system T cells to recognize his cancer.
The second step begins two weeks after the first step is complete. Using apheresis (a procedure that separates blood cells), a specialty center harvests the cancer-specific Tcells generated by the vaccine from the dog. These T cells are sent to ELIAS, where they undergo a proprietary process to produce a tumor-specific population of activated cancer-killing T cells. These are, in turn, sent back to the veterinarian for administration to the dog.
The ELIAS process activates the dog’s lymphocytes, priming them to identify, attack, and destroy the dog’s unique tumor cells. This immunotherapeutic approach targets specific cancer cells; it does not destroy other rapidly dividing cells like chemotherapy does.
While the vaccine is not a preventative and is therapeutic only after diagnosis, “the body also develops a memory of immune targets, which may lead to long-term control of tumors,” Dr. Bryan says. This could mean significant advances in survival and disease-free intervals.
The treatment is available through ELIAS Animal Health. “The collection of the tissue and administration of the vaccine and T-cell infusion could be performed by any veterinarian trained in the procedures,” Dr. Bryan says. For more information about ECI and whether your dog is a candidate for treatment, see EliasAnimalHealth.com.
Having lost two dogs to cancer, long-time WDJ contributor Barbara Dobbins follows canine cancer research news closely.
A yellow tint to the skin or gums, as seen here, is called
jaundice or icterus;
it’s caused by a
buildup of bilirubin.
A diseased liver can’t
filter and remove the
bilirubin from the
blood as it should.
Little attention is paid to the dog’s liver, part of the hepatobiliary tree (which also includes the gallbladder and bile ducts). The oversight is odd, because the liver performs many important jobs in the dog’s body. It’s responsible for everything from production of protein and clotting factors to mobilization of glucose from fat stores to provide energy. It metabolizes drugs and filters the blood. It can even regenerate if damaged. As much as 75 percent of the liver can be compromised before any clinical signs are seen. Due to its many functions, it is also susceptible to infection, inflammation, toxins, and cancers.
Signs of liver disease can include lethargy, decreased appetite, vomiting, diarrhea, bruising of the skin (small patches of bruising are called petechiae; larger patches are called ecchymoses), abdominal distention, weakness, and a yellow tint to the skin and gums (called jaundice or icterus).
Liver Tests for Dogs
If your veterinarian is concerned about liver disease, she may recommend several tests. The first and least invasive tests are blood tests, including a complete blood count (CBC) and chemistry panel.
The CBC evaluates red blood cells, white blood cells, and platelets, all of which can be affected with liver dysfunction.
The chemistry panel can evaluate values for individual enzymes released by the liver. These are the alanine transferase (ALT), alkaline phosphatase (ALP), gamma glutamyl transferase (GGT), and total bilirubin (Tbili). These tests are basic liver assessments, but they do not indicate actual liver function.
ALT is an enzyme that may be released with any source of damage to the liver. Blunt trauma, anaphylactic reaction, systemic illness such as thyroid disorders, and other problems that have nothing to do with the liver can cause an elevation of ALT in the blood. Just because ALT is elevated doesn’t mean the liver is failing, however. This result is interpreted in conjunction with clinical signs and other bloodwork and imaging changes.
In contrast, the liver enzymes ALP and GGT are released only in response to a problem in the hepatobiliary tree. ALP can also be found in the bones and intestines. Young, growing dogs will often have ALP elevations due to bone growth, while older animals with bone cancer can have high ALP levels, too. Again, an elevated value of this enzyme alone does not necessarily indicate disease.
Bilirubin is a yellow pigment found inside the liver and also in red blood cells. The liver metabolizes bilirubin, and when the liver is failing, blood levels of bilirubin will increase. This is what causes the yellow tint to the skin when a dog has jaundice.
The signs of advanced liver disease can be quite dramatic. The dog here is displaying widespread ecchymotic hemorrhage, caused by low clotting factors. Photo courtesy of Catherine Ashe, DVM.
The next assessment looks at the function of the liver. This is usually done with tests for bile acids, ammonia levels, and coagulation profiles. Bile acids are secreted by the liver in response to eating. Testing must be done while fasted; a blood sample is drawn, then the patient is fed, and another sample taken one to two hours later.
The liver is essential in making clotting factors. When it begins to fail, this ability is impeded, and uncontrolled hemorrhage can occur. There are specific tests to evaluate clotting times – called prothrombin time and activated partial thromboplastin time (PT and APTT).
Ammonia is a waste product, and when the liver is failing, ammonia levels will rise. All of these function tests are usually sent to outside laboratories for evaluation.
Imaging of the liver generally includes X-ray and ultrasound. More advanced studies may be conducted with CT scan or MRI with contrast. X-rays can determine if there is liver enlargement or large liver tumors, but it cannot show any of the liver’s internal architecture; ultrasound, CT, and MRI are used for this.
Samples of the liver can be taken in two ways. In a fine needle aspirate, a small needle is introduced into the liver and suction applied; then the sample is evaluated under a microscope. In a biopsy, a piece of tissue is taken via exploratory surgery or laparoscopically, and is tested with a culture and/or with a microscopic examination.
Types of Liver Trouble in Dogs
Given the complexity of this organ’s work, it shouldn’t come as a surprise that there are a number of different ways that the liver can be compromised. We’ll organize them by the type of problem.
Congenital Problems
The blood vessels in the liver normally have a very particular arrangement. Some puppies are born with extra or aberrant blood vessels called portosystemic shunts (PSS). Think of the liver as a blood filter; with a PSS, much of the blood bypasses the liver.
Symptoms of a PSS develop because the liver is not metabolizing properly due to the abnormal blood flow and the buildup of waste products in the blood. These symptoms may include abnormal behavior (particularly after eating), failure to gain weight and grow, and seizure activity. Liver function tests (such as a test for bile acids) and imaging can often identify the shunt. Surgery to improve blood flow to the liver is the treatment of choice in young dogs.
Some breeds are particularly prone to PSS. These include Yorkshire Terriers, Pugs, and Miniature Schnauzers.
Portal vein hypoplasia (formerly called microvascular dysplasia) is another congenital problem that can be present at birth or develop later in life. It is very similar to a PSS, and sometimes, it can be extremely difficult to differentiate the two based on the usual liver testing. The difference is that most dogs are asymptomatic, and the abnormality is found on routine pre-anesthetic screening bloodwork or at the time of another illness. The only change may be mild elevations of liver enzymes.
This Pomeranian is in the final stages of liver failure. The “pot belly” is a result of fluid accumulation in her abdomen. Photo courtesy of Catherine Ashe, DVM.
Infectious and Inflammatory Liver Ailments
Leptospirosis is an infectious disease, caused by a bacteria found in stagnant water such as ponds and puddles. It is most known for causing kidney failure in dogs, but it can also induce liver failure. The initial symptoms are vomiting, diarrhea, lethargy, fever, red, painful eyes (uveitis), and sometimes muscle pain and stiffness or cough. Illness can be severe and life-threatening.
There is a leptospirosis vaccine, but it’s generally considered a “lifestyle” vaccine – meaning that it may not be appropriate for all canines. For example, dogs who have little or no access to puddles or ponds may have little risk of encountering the leptospira bacteria, making the vaccine unnecessary. But the fact that leptospirosis is zoonotic (humans can contract the disease) makes some veterinarians (including me) recommend the vaccine for all dogs. It’s best to discuss this vaccine with your veterinarian.
Hepatitis is a general word for liver inflammation. There are several types in dogs, including infectious hepatitis and inflammatory hepatitis. Copper storage hepatopathy is a well-described disease in which the liver accumulates too much copper. Predisposed breeds include Labrador Retrievers, Doberman Pinschers, Bedlington Terriers, and West Highland White Terriers.
Canine adenovirus can cause an infection in the liver. Vaccination has largely eliminated this condition although it can still occur in unvaccinated dogs.
Toxicity-Induced Liver Trouble
The liver is especially susceptible to toxins. As a filter for the body, it metabolizes many of the substances in the blood.
Xylitol is a common sweetener found in kitchens, especially those of diabetics. It prevents wide fluctuations in insulin and glucose in humans. In dogs, however, it can cause a hefty insulin release. This drives blood sugar down, leading to hypoglycemia. The symptoms occur within 30 minutes of ingesting xylitol, and include weakness, tremoring, seizures, and coma. If a large enough dose is ingested, liver failure will occur. This can take two days to a week to manifest, so just because your dog isn’t showing any immediate symptoms doesn’t mean the ingestion should be ignored.
Xylitol is also included in sugar-free gums and candies, as well as some compounded medications and peanut butter. Always check for the presence of this chemical before giving your dog a new treat or compounded medication.
Sago (cycads) palm are another source of deadly liver toxins. These plants were once isolated to subtropical and tropical areas, but today, sago palms are now available almost anywhere. They are extremely poisonous to dogs, leading to death within a day to a week after ingestion. Every part of the plant is considered toxic, so these should not be kept in homes or in landscaping where dogs are present.
The initial symptoms of ingestion are rapid in onset (within minutes to a few hours) and include drooling, vomiting, diarrhea, and lethargy.
If you suspect your dog has eaten sago palm, do not wait to see if symptoms manifest. Immediate and aggressive decontamination is needed. Your veterinarian will likely induce vomiting to remove any sago palm from the stomach, give activated charcoal to prevent further absorption, and then start intravenous (IV) fluids.
Aggressive treatment is absolutely imperative. Most dogs who ingest sago will spend anywhere from a week to two in the hospital. Treatment will include IV fluids, nutritional support, antibiotics for secondary bacterial infections, and other advanced therapeutics such as fresh frozen plasma transfusions and vitamin K administration. Liver values and clotting times will be checked at least daily and maybe more often. If your dog isn’t eating, a feeding tube may be placed through the nose or IV nutrition given into the catheter. The prognosis for survival, even with treatment, is only about 50 percent.
Beware the Deadly Sago Palm
Dr. Kimberly Chambers is a veterinarian in Conroe, Texas. She knew that sago palms (Cycas revoluta) were poisonous, and so when she moved into her beautiful new home, she had the sago palms in her yard cut down and removed.
Some time later, Dr. Chambers adopted a puppy, Theo.Last June, at four months of age, Theo was digging in the yard and – apparently – dug up and chewed some roots of the palm that were still in the ground.
Dr. Chambers didn’t see this happen, but about an hour after he had been outside digging, Theo vomited in the house. The bits of the root jogged her memory; she realized it was likely sago palm roots. She induced Theo to vomit some more, and then drove quickly to the closest specialty veterinary hospital.
At first, it seemed as if Theo might have been treated fast enough. He had only mild elevations in his liver enzymes. He was sent home with liver supportive medications and orders for Dr. Chambers to monitor him closely. But his appetite was poor. He grew, but he remained thin.
Weeks later, since he was still underweight, Dr. Chambers had Theo’s liver imaged with ultrasound. With that, the damage the sago had done to Theo’s liver finally came to light. Despite its ability to regenerate, the liver can withstand only so much damage. Theo’s liver had marked fibrosis (replacement of healthy tissue with fibrous, non-functioning tissue). He also had some fluid in his abdomen secondary to low proteins and a “leaky” liver.
Over the next few weeks, Theo’s abdomen continued to accumulate fluid. Dr. Chambers would drain his abdomen via abdominocentesis, but because of his damaged liver, the fluid always returned. One day, Theo didn’t want to come out of his crate and he didn’t want to eat. His gums were pale and his belly was bloated. Dr Chambers knew it was time. She and her family fed Theo brisket for dinner and breakfast (with whipped cream). And then they said goodbye to him in the most peaceful way possible.
Theo fought a tough battle, but despite early and aggressive, expert care, he died. He serves as an important reminder to keep all sago palms out of houses and yards where dogs live.
Exposure to the toxins in blue-green algae can be fatal within minutes. Blue-green algae (more properly called cyanobacteria) can be found in freshwater lakes, ponds, and brackish water but also in less obvious places, such as aquariums. Algae can be present throughout the year, but is found in higher concentrations in warmer months. Not all blue-green algae makes toxins, but you cannot determine that by looking. Thus, never allow dogs to swim in water with algal blooms.
Cyanobacteria can produce two primary types of toxins: anatoxins, which cause sudden death due to respiratory paralysis, and microcystins, which lead to liver failure. Symptoms of microcystin toxicity are similar to those of other liver toxins and include vomiting, diarrhea, lethargy, and lack of appetite. If blue-green algae ingestion is suspected, do not delay in seeking treatment. As with other toxins, it will center on supportive care, as there is no antidote.
Medications are a common source of deadly liver toxins. Several medications that are frequently used by humans have been implicated in canine liver failure. Acetaminophen can be used at safe levels in dogs. It is often used in oncology when combined with opioid medications to control cancer pain. Like any substance, the dose makes the poison. At high enough doses, acetaminophen can cause liver failure.
Carprofen, a common non-steroidal anti-inflammatory drug (NSAID) used for the treatment of pain, has been implicated in liver failure. Why some dogs develop this rare problem is unknown. Overall, carprofen is an extremely safe choice for pain control but, rarely, a dog will develop problems. This may be more common in Labrador Retrievers for unknown reasons.
Because of its reliance on the liver for metabolism, phenobarbital can lead to liver failure in some cases. This is a ubiquitous medication in veterinary medicine, used in the control of seizures. Dogs on phenobarbital will need monitoring of liver values, and if indications of hepatic damage occur, may be switched to a newer anti-seizure medication such as Keppra or zonisamide.
Acquired Liver Problems
Some liver ailments are acquired over time, not from an acute insult. Vacuolar hepatopathy is an age-related condition characterized by liver cells (called hepatocytes) that appear swollen and foamy under a microscope. Liver cells accumulate damage over a lifetime; when stressed, they respond by swelling and developing vacuoles – little fluid-filled cysts inside the liver cells themselves. This often results in an enlargement of the liver. This non-specific change can be insignificant or linked to a host of illnesses.
Some of the most common causes of vacuolar hepatopathy are long-term steroid use or chronic steroid overproduction (as in Cushing’s disease) and the use of phenobarbital for seizure control. The findings on bloodwork can be nonspecific but generally include an elevated ALP. If your dog is otherwise healthy and asymptomatic, your veterinarian may not be alarmed by this test result. However, if there are symptoms of illness, more testing is indicated.
The liver does develop cancers. The most common are hepatic adenocarcinoma and hemangiosarcoma. There may be no symptoms as liver cancer develops. Sometimes, a large liver tumor is found on routine examination or through senior bloodwork. This is the ideal situation. If found incidentally, many liver tumors can be successfully removed. Hepatic adenocarcinomas are often completely cured by removal, as they are slow to metastasize.
Hemangiosarcomas, in contrast, are much more aggressive tumors. They grow silently and then rupture. Often, they are discovered when a previously healthy, older dog collapses suddenly. Surgery will address the hemorrhage and remove the source of bleeding, but by the time they are discovered, these tumors have already spread. Surgery alone can yield up to three months of survival time, while adding chemotherapycan increase survival to six months to one year.
Liver Support for Dogs
There are many medications that your veterinarian may use to treat your dog’s liver disease. But there are also several good over-the-counter supplements that can help support a damaged and healing liver.
Denamarin and vitamin E have antioxidant effects in the liver, as well as some anti-inflammatory properties. Denamarin is a canine-specific product containing silymarin, an extract of milk thistle, which offers particularly good anti-inflammatory action. Vitamin E is a fat-soluble vitamin found in high concentrations within the liver. Both supplements can be used in addition to conventional medical treatments to support a damaged liver.
Turmeric has recently received increased attention for its anti-inflammatory effects in both human and veterinary medicine. While there are no large, controlled studies evaluating its efficacy, it is safe for use in dogs. A word of caution: Don’t buy from sketchy online sources or administer human products. Seek out a reputable veterinary product such as CurcuVet made by ThorneVet (available from Amazon and many veterinarians). Internal quality control is essential in finding a good product.
